anal problems possibly fistula?

Question

I have suffered from a painful abcess that I think has become a fistula. After a warm sitz bath I notice a stringy discharge from the sentinal tag that has formed after the abcess has healed. There is definately something wrong and it is very, very painful. This has been going on for over 4 years now. I've been to 6 proctologists and because I am unable to take HIV meds, all refuse to treat me. CD4 count 185, Viral Load <100,000.
Suffering in South East Michigan, Thanks for your help.

Answer

Thank you for your post.

I've got a number of questions that are raised by your post-- first off, why exactly are you unable to take HIV medications? This seems to be related to why your doctors refuse to treat you, but I'm confused by this. Is it because of side effects? Were there issues with adherence or missed appointments? In any event, there's no clear link between why your anorectal doctors won't treat you- our colorectal surgeons here in Colorado simply don't use antiretroviral medications as a criteria for treatment.

You clearly have HIV lab tests that indicate that you'd probably benefit from being on antiretroviral medications. As for your anorectal symptoms, it seems like there's need for a reassessment.

Best of luck, BY